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This literature review has emphasised the overall perception of Black and minority ethnic groups regarding screening for cervical cancer in the UK. Along with that, the overall impacts of the Covid-19 pandemic and its influence over Black and minority ethnic groups regarding cervical cancer screening will be emphasised with the help of different literature. The literature part will investigate the overall assumption of the BAME Groups that will be mainly related to the screening process for cervical cancer in the UK. Nearly cervical cancers are caused by the HPV virus and that are highly infected virus which can occur due to the skin contact, oral sex, anal sex or vaginal sex. This literature review examines the cervical cancer screening rates in BAME group. The literature part of the study describes that in the UK women aged between 21-29 years, screening rate is 8% in the year 2020 before the lockdown whereas the rate has increased in the lockdown period. The literature part of the study analyzed various negative behaviors between them and that are mostly due to the screening process to reduce the disease.
The health belief model can be described as the theoretical model that helps in assessing health promotion and disease prevention programs. As opined by Sulatet al. (2018), the health belief model can be used in overall explanations and predictions of health behaviour changes. This model has been considered a widely used model for the understanding of health behaviours in the context of any disease. Through this model, an overall prediction regarding health-related behaviours can be predicted on the basis of different beliefs of individuals. Individuals' beliefs on the different health conditions can be turned into health behaviours and that analysed through a health belief model improves the overall idea about different health-related behaviours (Sulatet al. 2018). Assessing and identification of different health-related behaviours help in the overall health promotion of an individual which further helps in preventing diseases and promoting healthy lifestyles.
Some of the Health sector study delivers that cervical cancer is the second leading cause of death among the worldwide whereas tenth leading cause falls in the cancer related diseases. The health belief model that was developed in the year 1950 for improving the health worldwide related to the health service and also motivates patients to participate in the major programs which enable them to detect and prevent the disease (Enyanet al. 2021). This model mainly aims to explain preventive behaviors of BAME groups rather than behaviors in the illness period (Okanet al. 2019). The further part of the model was usually demonstrated for the responses of the people to identify the symptoms and the behavior that usually happens in the illness. The health belief model in the UK among cervical cancer patients focuses on the prevention of exposure to various diseases at their no symptomatic diseases stage, The model includes various concepts and determination tools that describe why people need to take immediate action to prevent, to avoid screening or to control the disease conditions (Amos and Awolude, 2019). Though, this model assumes the behaviors of the health and are mainly motivated by the five elements and that includes perceived benefits, perceived seriousness, perceived susceptibility, cures of the action and the last one and most recently factors is perceived self efficacy.
The model is extensively used in the various health sectors for describing the determination of the relationships between the health beliefs as well as the health behavior of the patient. In this way, the health belief model plays a vital role in the field of medicine and cervical cancer disease is most often used in the process of screening tests and identifying the behavior.
Perceived barriers can be referred to as the major reason that affect overall health behaviours regarding cervical cancer screening. Social consequences, expenses related to treatments, and health discomfort are the major reasons that affect overall health behaviours regarding cervical cancer Along with that, as the Covid-19 pandemic massively impacted the health behaviours therefore different barriers have also predominantly been identified as the potential barriers to health behavioural changes.
Cues to action can be referred to as the external factors that have the potential to change the health behaviours of certain diseases (Groves and Brooks, 2022). Different external factors have been identified as a cue to actions regarding behavioural changes such as health fairs, health-related posters, death of relatives and others.
In the Health belief model, Self-efficacy can be described as the ability of an individual to make a behavioural change in aspects of a certain disease (Amos and Awolude, 2019). However, the Covid-19 pandemic has massively impacted the personal behaviours related to health; an increment in self-efficacy can help black and ethics groups to change their behaviour toward cervical disease to avoid that disease and for healthy lives.
Anderson's healthcare utilisation model can be described as the concept-based demonstrations of the determinants that lead to implementation in healthcare services (Seidu, 2020). Anderson's healthcare utilisation model adequately addressed different culture and social interaction that comes under predisposing factors. On the other hand, this model also emphasised the different health beliefs and structure that helps in enhancing overall concepts regarding healthcare utilisation.
As per the opinion of Seidu (2020), usage of health services such as cervical screening uptake can be determined through the Anderson health care utilisation model that consists of three main factors predisposing factors, enabling factors, and need.
These factors have been referred to as socio-cultural factors in an individual that exists in order to prior their illness (Afayaet al. 2020). These factors are further categorised into the three parts such as social structure, health beliefs and demographic factors. Social structure education, social interactions, social culture, education, occupations, ethnicity and others impact the overall behaviours related to health beliefs that further influence cervical cancer disease. Predisposing factors have been characterised as race, age, health beliefs, ethnicity and others that impact the overall health-related behaviours of an individual. As the cultural factors of black and minority ethnic group beliefs of the early age for giving birth to a child, therefore these cultural beliefs regarding health status can be greatly impacted overall health behaviour (Seidu, 2020). The case of the Covid-19 pandemic massively impacted the health behaviours of black and minority ethnic group’s people of the UK.
As opined by SoleimanvandiAzar et al. (2020), enabling factors such as personal and community factors have helped in seeking healthcare services for individuals. Family support, access to healthcare insurance, ethnic and community support and other factors help in assessing healthcare services that increase overall promotions of healthcare. Along with that, different psychological factors can also be effective in terms of enabling factors that increase overall healthcare services. As the Covid-19 pandemic massively influences social and healthcare services, therefore the importance of enabling factors needs to be enhanced that help in increasing overall lifestyle (Nelson et al. 2021). Along with that, for the black and minority ethnic groups people of the UK that have not predominantly assessed healthcare services faced issues related to cervical cancer. These factors can be identified as the effective factors for the black and minority ethnic groups in terms of awareness among large segments of people related to cervical screening as well as increase the ability to fight against the different barriers that hinder the overall process of uptake among the blacks and other minorities in the UK.
Anderson's model of healthcare utilisation indicates the overall importance of healthcare services and their implications for different situations (Groves and Brooks, 2022). In the case of the Anderson model of healthcare utilisation, two types of needs can be developed in context with assessing healthcare services and their implications. Perceived has been described as the perception of individuals on their own health and functional problems such as symptoms of illness, worries about health, pain and others (Stumbaret al.2019). On the other hand, evaluated needs can be described as the professional judgements regarding people's health and status that are necessary for medical care. Therefore, the case of black and minority ethnic groups in the UK can be analysed properly in order to access healthcare services.
Cervical cancer is identified as one of the common diseases that occur in the cells of the cervix of female reproductive organs. Cervical cancer is one type of gynaecological cancer that affects women between the ages of 30 to 45 mostly. Therefore, in this context encourage screening uptake to the black and minority ethnics group of the UK that have been ignored these services such as minorities reported in previous studies (Nelson et al. 2021). In case of analysing and identifying the overall causes of cervical cancer, it has been identified that most of the cases are linked with a high level of infection and related to Human papillomavirus (HPV) has been one of the common viruses that have been transmitted through sexual contamination (Cdc.gov, 2022). HPV has been identified as the most common virus transmitted during sex. However, almost half of the sexually active people have HPV in their lives, though few women only have suffered from cervical cancer.
As opined by Stumbaret al. (2019), there are two types of cervical cancer that need to be determined from the treatment process and prevention method of the disease. “Squamous cell carcinoma” and “Adenocarcinoma” have been considered the two main cervical cancers. Most cervical cancers are squamous cell carcinoma that is predominantly identified in the thin region of squamous cells laying on the outer part of the cervix (Groves and Brooks, 2022). On the other hand, cervical cancer, “Adenocarcinoma” identified in the region of column-shaped glandular cells within the cervical canal. A cervix cell has been affected by cervical cancer. In the case of prevention methods, screening tests uptake with a “rapid HPV kit” or the identification of HPV using the conventional screening methods can be effective in terms of preventing the increase of cervical cancer and increasing early detection (Pimple and Mishra, 2019). Therefore, in order to prevent cervical cancer and increase overall health behaviour, the “black and minority ethnic groups” of the UK need to increase awareness about the disease.
The fate of cervical cancer in the UK every year is about 3,200 new per year. The rate of the prevalence of cervical cancer in the UK every year is 592.32 from 100000 people. The reason behind the cause of cervical cancer is the HPV virus which is transformed from one person to another person by physical contact during sex. A pap test is to find the rapid result for cervical cancer in women in the cervix (Cdc.gov, 2022). However, to prevent from this disease people must take preventive measure before sex. The proper take care of this matter is necessary for the prevalence from this type of cancer for the women.
In the UK, cervical cancer has been identified as a major medical issue that needs to be analysed properly to increase the overall healthcare services and provide better prevention for this disease. Around 3200 new cervical cancer cases have been identified in the UK every year which further indicates around 9 people every day (Cancerresearchuk.org, 2022). On the other hand, around 853 deaths have been reported from 2017 to 2019 in the UK due to cervical cancer disease. However, a 51% survival rate has also been reported between the years 2013 to 2017 in the UK which assists in increasing the prevention cases of cervical cancer.
The above figure shows that most of the women that are affected due to cervical cancer are between 25 to 40 years old, indicating the rates of cervical cancer disease predominantly found in young aged women in the UK. The UK has been working on the achievement of the WHO “cervical cancer elimination strategy” targeting around 2030 which included the prevention of 90% of girls fully vaccinated with the HPV vaccine at the age of 15 (Cancerresearchuk.org, 2022). Along with that, 72% of women are screened with high-performance tests at the age of 35 years and again at the age of 42 that are identified as cervical cancer affected. Improvements in public awareness of the black and minority ethnic groups increase screening uptakes, and HPV testing is the major factor that needs to be increased for the betterment of these minority groups in the UK.
The rate of cervical cancer in the UK has increased by 2.6% in past years among the age group of 20 to 24 (Cancerresearchuk.org, 2022). Along with that, around 62% of women aged between 24 to 29 years have been attending the screening. In the case of black and ethnic groups in the UK, the overall rate of cervical cancer screening has been observed as lower than that. In the case of the overall awareness related to cervical screening tests has been identified as 50% only (Waller et al. 2020). After the massive impacts of the Covid-19 pandemic on the health sector of the UK, the overall rates of cervical screening test has been decreed affecting directly health-related behaviours of people. Therefore, an increase in awareness related to cervical screening's importance to the minority group of the UK needs to be developed that helps in increasing the rates and promoting overall health behaviours of people.
In the case of assessing different risk factors for Cervical cancer, a set of medical, physical and external factors has been identified that are associated with cervical cancer.
The potential risk factor for cervical cancer has been identified as the infection of Human papillomavirus (HPV). This is the most common and widely identified medical risk factor for cervical cancer that occurs during unprotected sex. Through the form of “Squamous cell carcinoma” and “Adenocarcinoma” cervical cancer has been identified in the outer cervix cells and on the cervical canal (Fu et al. 2019). Along with that, skin-to-skin contact has also been identified as another factor that has been related to HPV infection and causes one of the risk factors for cervical cancer.
Different factor related to an individual's sexual history has been identified as the major risks factor that increases the risk of cervical cancer. The different sexual histories of individuals increase the chances of exposure to HPV. In the case of sexual history, having many sexual partners can be determined as the major reason for increasing the transmission disease of cervical cancer (Mayoclinic.org, 2022). As the Covid-19 pandemic has been identified as a commonly transmitted disease, therefore the rate of sexual transmission can massively impact the overall risks of cervical cancer.
As stated by Pesola and Sasieni (2019), HIV causes AIDS disease weakens the immune systems of individuals that further increase the risks of HPV infection and cervical cancer. As Covid-19 pandemic massively influences the social behaviour of people that increases the rate of drugs and other consumption due to lockdown factors. On the other hand, due to an increase in social distance and other factors, a massive health behaviour change has been identified that increases the overall risks of cervical cancer.
As opined by Nagelhoutet al. (2021), Smoking has been considered a risk factor as the consumption of tobacco materials causes different cancer-causing materials that increase the rate of “Squamous cell cervical cancer”.
Presence of other sexually transmitted infections
The presence of some of the major sexually transmitted diseases such as gonorrhoea, syphilis, AIDS and others can increase the rate of HPV transmission. As opined by Fu et al. (2019), the presence of a major sexual disease can increase the chances of cervical cancer during sexual transmission that contains HPV transmission.
Multiple full terms pregnancies
In the case of identifying the risks of cervical cancer, multiple full-term pregnancies have been identified as the major risk factors that increase the rate of HPV transmission (Groves and Brooks, 2022). In context with the black and minority ethnics group of the UK, a cultural factor has been identified that impacts the multiple pregnancies issues and that causes cervical cancer in those people.
Worldwide, cervical cancer is one of the most common and serious diseases whereas the UK has faced lots of problems with this disease. Cancer is a very serious disease which has less prevention and scientists are currently working on how to cure various diseases related to cancer. Different cancer diseases have different types of risk factors and that are very important for mitigating the chance of developing cervical cancer (Razaiet al. 2021). Although. The risk factor can also increase the odds of developing cervical cancer and exploring the risks cannot develop this type of disease. It is earlier discussed that the disease mainly occurs due to the infection of the virus HPV and that is the most vital factor for the disease. These viruses mainly live in a group and are associated with 150 related viruses. HPV may infect various cells on the surface of the skin in a body and those are also lining with the anus, mouth and throat but are not found in the internal organs such as lungs, hurts or intestines (Cancerresearchuk.org, 2022). Like other infection related disease this disease also spread from one person to the other person during skin-to-skin contact and that includes various activities like and includes the contact process of vagina, anal and mostly oral sex. Certain types of HPV can cause some warts around the male and female genital organs and in the anal part also. Protecting an individual by getting infected is the most important cure for having a disease. These are classified as the low-risk types of HPV as they are seldom like the cancer and cervical cancer falls on that list (Davies-Oliveiraet al. 2021). Having a weakened immune system can also be identified as the risk factors related to cervical cancer in the female. Taking birth control pills increases the risk of having cervical cancer, but research shows that stopping taking birth pills can mitigate the risks.
Through cervical screening, and overall precancerous change can be detected that helps in treatment procedures for cervical cancer. The target audience of cervical screening has been identified as 25 to 64 cervix-aged women in the UK (Gov. UK, 2022). In the UK, all the eligible women that are registered with a GP can get an automatic email initiation for screening tests. In case cervical screening can be identified as the advantageous feature of cervical screening that helps increase screening uptake. However, after the massive impacts of the Covid-19 pandemic the overall screening possess has decreased due to government-imposed emergency lockdown (Wilding et al. 2020). On the other hand, people with low economic status such as the minority group of the UK have not got the overall screening invitation due to a lack of awareness and poor economic background.
Cervical cancer is often prevented by having regular screenings in which pap tests and HPV tests are used to find the solution and getting the way of treating them. Screening process mainly used to detect early cancer before or precancerous changes before signs or symptoms of having a cervical disease. Medical field has invented so many techniques for evaluating various symptoms of the disease and prevention of the disease. This technology is mainly processed for testing the symptoms of cancer related disease and that are used to screen a person in identifying specific types of disease before signs or appearance of the symptoms. The main goal of the cervical screening is to reduce the number of deaths who are mostly dying with cervical cancer and completely eliminate the chances of having this disease (Bennett et al. 2018). It is also used to reduce the number of the people who develop this serious disease. Some of the tests and effective procedures are used to screen for cervical cancer in the medical related field. HPV test is one of the famous tests that are processed for cervical cancer disease. This test is mostly done on the sample of cells and removed from the cervix and that is used for the other test that is pep test as well. This sample is collected and tested for finding the strains of the virus and that is the most important thing which is commonly included with cervical cancer disease. This t5est also be processed on a sample of cells as well from the cpart vagina and that is the process, which can be processed by the person on their own (Abraham et al. 2022). Pap test is the other important procedure and identified as the most common test for the early changes in the cells and that are mostly lead with the cancer related field and the process is determined as Pap smear. It is often done at the same period as a pelvic exam in the part of the gynecologic checkup. Visual inspection with acetic acid is the last and important procedure that is mostly used to screen disease like cervical cancer (Marlow et al. 2019). During the process of VIA, some chemicals used for the violation process are known as a dilute of the white vinegar and which are mostly applied in the main part of the female that is in the cervix. The health care provider has various abnormalities as well on the cervix and that will turn exposed to the vinegar. In the medical field, these procedures are determined as a very useful process as it is included with lack of access to the medical care and that are very less limited. There are around 850 cervical cancer deaths in the UK every year and that has seen that it increase more than 2 every day. Over the last decade, cervical cancer mortality rates in the country UK decreased by around 18% in the females (Kirubarajanet al.2021). Mortality rates in the estimated due to these serious problems can fall 8% in the UK as the medical field is getting advanced day by day.
Different barriers have been identified as the major causes that impact negatively on the cervical screening uptakes for the black and minority ethnic groups of the UK related to cervical cancer disease. As opined by Patel et al. (2020), awareness has been considered the prominent barrier to cervical screening uptakes for the black and minority ethnic groups of the UK.
Through proper awareness, an overall increase in healthcare assessment can be achieved. overall screening uptake process and mortality rate can be decreased in the case of minority groups. As opined by Christie-de Jong et al. (2022), a lack of awareness increases the mortality rates and decreases healthcare promotions. Low awareness levels have directly linked with race, socio-economic stability, and ethnicity which further hamper the screening-related knowledge and information gatheringCultural difference
Cultural differences among the ethnic minority groups can be considered one of the major barriers to HPV screening uptake for cervical cancer diagnosis. As opined by Kirubarajanet al. (2021), differentiation of health beliefs and differentiation in health related behaviours has been identified as the major difference between the majority white groups and ethnic minority black groups of the UK regarding HPV screening uptake has hampered the overall process that further impacts of their physical and mental health also.
As the UK is a widely diversified country that includes different cultures and different languages, therefore language barriers have been identified as the major barriers in the case of minority ethnic groups. As opined by Gottschlichet al. (2020), lack of knowledge regarding mainstream language among the ethnic minority groups has created a barrier to the overall awareness program that reduces the rates of attendance on the HPV screening tests. Along with that, consisting of different misconceptions regarding cervical cancer disease and its different aspects hinder the screening tests.
Cervical screening is a process of health checkups of the cervix and this is not a cervical cancer identification test. This process covers the checkups for preventing cervical cancer and this considers middle-aged women of age between 25 to 64 (Stuart and D'Lima, 2022). This screening part faces some issues and this brings down the checkups rate. Therefore, this makes hides the actual numbers of diseased people. The barriers part of this screening process includes two reasons such as personal barriers and structural barriers. Personal barriers happen due to embarrassment factors, lack of information about the risk factors, other chronic diseases and lack of availability of female physicians (Ferdous et al. 2018). In addition, barriers to this part affect the covid-19 applications as the patients do not want to take the covid vaccination drive as those people think that this may reveal their personal information. This makes the issues in the covid campaign as those non-vaccinated people may spread the covid disease in society.
Structural barriers include reasons of costs, workloads, and transportation issues, non-availability of physicians and lack of English proficiency. The knowledge factors deliver the condition of BAME in this list as those people do not have enough literature efficiency and this makes the people not aware about the treatment and precaution part of this disease. In addition, the anxiety factors cover the 3rd place in the barrier list. Data shows that 38.7% vote in anxiety factors include this factor (Marques et al. 2020). The embarrassment factor makes in the barrier list as this factor captured 25.6% of votes in the barrier list (Dhillon et al. 2020). Another data shows that Spanish and US women are more involved with the co-testing part of cervical screening. The analysis in this part shows that 49.1% of black women show that they are not interested in the co-testing part of cervical screening (Vincent et al. 2020),. In addition, Hispanic women are more interested in this testing part as the data shows that 68.2% of Hispanic women involve in this testing part (Christie-de Jong et al. 2022). This data shows that the literature varies this interset part as the Hispanic women complete more education as compared to the minority people.
In the case of cervical screening uptake among the black and other minority ethnic groups in the UK, it has been identified that they have been possessing "Poor health-seeking behaviour" that results in the low uptake of healthcare services as well as cervical screenings.
Poor health-seeking behaviours
Poor health seeking behaviours has been identified as the major issues that have been observed during the pre-pandemic situation that affect the overall cervical screening among the minority ethnic groups. As opined by Watson et al. (2019), traditional and cultural health beliefs can be identified as the root cause of poor health seeking behaviours that impacts negatively on the overall health (Mishra et al. 2021). “Structural racism” can be described as policies, practices, structures, and norms that result in accessing differential services. As opined by Arday (2018), in the case of pre-pandemic situation inequality in the healthcare services has existed in terms of black and ethnic minority groups of the UK impacts on the overall health behaviours of those groups.
Cervical screening uptake is the rate of screening tests in various aged women. This part considers the Qualitative SLR data collection process to collect the needed information on this screening rate. In addition, the previous data shows that screening uptake shows a small value in young-aged women. This data consider the data of 25-29 years aged women of deprived areas and minority people in the UK (Razaiet al. 2021). In addition, this part of the study wants to cover the screening part on the highly risked women and to solve these issues there is a need for a strategy to make solutions of these issues. Uptake is a screening record in a year of the invited women and this record keep in a list to show the result of screening uptake of that year. The rate of cervical screening is less in the pre-covid period as the people followed a busy routine to complete their daily activities and this made the people stay outside of their house. This rate changed after the covid-19 pandemic as the number of screened people increased after the spreading of covid-19. This has occurred due to the maximum number of people completing their activities in their own place as the lockdown happened in the entire world and this develops the rate of involvement of people in sexual activities during this period. Therefore, this increased the rate of screening uptake in a year after the covid-19 pandemic and the data shows that cervical cancer captures the 2nd position in the list of all diseases in the entire world and this disease captures the 2nd position in the list of cancer diseases in the UK (Hampshire et al. 2021). The world needs to think about the solution part of this disease as this disease has a large negative impact on the entire female parts of the world.
The covid-19 pandemic has a large contribution to the screening uptake and this makes a tense situation for the entire world. The pandemic period makes various reasons for people and these effects on the involvement part of people in sexual activities. Lockdown provides the barriers in the personal wish part of the people as many people meet their personal needs by taking some illegal options in sex. This pandemic makes it difficult in this part as the government announced a lockdown in the entire country. In addition, the people cannot able complete their satisfaction part in other activities outdoor as people are stuck in their individual places. Therefore, this raises the mental pressure on the people and the people involved more in sex (Wilson et al. 2021). Therefore, the HPV virus spread more in women and this occurs cervical cancer in women. In addition, the people face mental pressure as many people lost their job during the lockdown phase and stay in their own houses. This influences their sexual activities and this arise the rate of screening uptake. As the people do not have enough work to do while staying in their own place, the people involved in this activity. The minority and black people involved in this disease as those people do not have enough education and awareness.
Health-seeking behaviour affects in this part as the women do not want to take vaccination drive due to the presence of HPV virus. This results in the lack of vaccination drive in those BAME groups in the world. However, the cervical uptake covers 84% of home services as the women want to complete this screening process in the home to secure their personal information (Davies-Oliveira et al. 2021). In addition, women get difficulties in the cervical screening part of the pandemic period as the women fear the covid virus as the women think that they may be infected through covid disease while taking the screening process. Therefore, this may reduce the intake of this screening part and the BAME people have a negative impact on covid-19 as the people do not have the facility to be aware of the negative effect of cervical cancer and HPV virus as those people stuck in the house.
In addition, the UK has been affected in large numbers as the people face the wave of covid-19. Therefore, the entire world and the UK covers the lockdown phase to reduce the spreading covid-19 virus. Therefore, the country faces issues in the health part as the people face the fear factors of the virus and the health places have not enough seats for the people as many people admitted to health organisations due to the illness of covid-19. The health facility faces issues in the transportation part as the people face issues in this part (Colombo et al. 2021). The entire lockdown makes issues in the transportation part and the people cannot go to the health sector to cure their disease. The rural area and minority people face this issue as the people do not have enough extension in the facility part and the transportation system has not considered the needed options for those people. Therefore, people face issues taking awareness of the HPV virus and cervical screening part due to the unavailability of the awareness campaign and least the availability of treatment facilities in rural and minority areas of the company.
The above figure shows that in the UK the overall cervical uptake screening rate has decreased in the last decade which affects the overall cervical cancer related health services. Around 5.7% of cervical screening uptake has decreased in the UK in the last decade from 2011 to 2021 (Statista.com, 2022). Along with that, from the above figure, it has been identified that around a 1% overall decrease has been observed in the case of cervical screening uptakes. During the pandemic situation, the rates of cervical screenings have decreased as shown values around 71.9%, and 72.2% in the respective years of 2019 and 2020 (Statista.com, 2022). Therefore, the impact of Covid-19 on the healthcare sector of the UK massively impacted the overall behaviour related to healthcare such as cervical screenings and others.
This structured literature review has tried to bring information related to the Perception of BAME groups in the UK and health related behaviours regarding cervical cancer. The study faces issues in the literature part of this topic as this part considers taking the need for help from various sources. However, the methodology part does not cover the entire needed parts so the research gets the needed requirements in this topic. This study does not complete every required information on the topic as this part does not get enough data from the journals and books. In addition, this study also faces issues in the website's sources as this part has not enough data on the cervical uptake part and this makes the topicless authentic. The study faces issues as the covid-19 virus puts various rules in the travels part and therefore, the study can not complete the data collection part in various remote places in the study to complete the entire research data collection part. This affects the research methodology part as the affected people have not considered this study due to less availability of the options in the research work. Many women who face issues with this disease do not want to disclose their personal information about this research and this makes a reason for the non-availability of the research data on this topic.
The study summaries the effect of cervical cancer in the UK and in the entire world as the study mentions various information about this topic. The study shows the SLR data collection part in the methodology to collect the information on cervical cancer in the UK and this data collection part shows the issue in the BAME part of the UK that is affected most by this disease. In addition, this research includes the reason for the lack of cervical screening part and mentions the cervical uptake part before and after the covid-19 period. In addition, the study includes the health behaviour during the lockdown period and delivers the reason for facing challenges in this period of a covid-19 pandemic. The study includes the mitigating part of the issues to enhance the quality of the BAME people.
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